University of Stirling, Health Sciences

Maintaining the functional ability and quality of life of patients leaving hospital


Carrie Milligan

Carrie Milligan graduated from the University of Stirling in November 2016 with a Masters in Advanced Practice. Her dissertation was a Quality Improvement Project and focused within her work place.

She was awarded a Research-Based Learning Prize for her dissertation titled: Maintaining the functional ability and quality of life of patients leaving hospital: improving information sharing with care home staff on discharge from an organic assessment ward.

 We found out about Carrie and her work:

Tell us about your project:

I am a Specialist Occupational Therapist working in older peoples’ mental health. The project was focused in the organic assessment ward that I work within. It looked at the communication process from the inpatient setting to the care home. Our patient group is complex, and admission lengths at the commencement of the project were, on average, 98 days. There is some evidence that patients’ quality of life and functional ability decreases on discharge from hospital.  I wondered if improved information sharing could also lead to improved outcomes for patients.

The discharge communication process is reliant on one nurse disseminating the assessments, interventions and treatments of the multi-disciplinary team on discharge.  This means that important information from other clinical disciplines, such as occupational therapy, were not being shared with care homes when patients were discharged from hospital. Consistent and timely information sharing between the multidisciplinary teams hospital and care home staff sounds simple, but is not as straightforward as it seems.

What was the aim of your project?

I aimed to develop and implement a new information care procedure to make sure care homes were receiving all appropriate information about a patient when they were discharged.  We were interested to find out if this process would also lead to improvements in patients’ quality of life, functional ability and Body Mass Index (BMI) on transfer.

 How did you carry it out?

 I used various methods recommended by the Improvement Science approach. A new discharge form was created through consultation with members of the multi-disciplinary team and community staff, including social work. Staff engagement was vital. Continuous education about the new project was required to inform and engage with new ward staff.

The impact of the project was measured using questionnaires with staff in the ward, care homes, and the liaison mental health team. Patient outcomes were measured using quality of life and functional ability scales, and body mass index (BMI) before and four weeks after discharge. Audits of the new discharge form measured how regularly and correctly staff were using the form.

 What was the impact of your project?

Twenty patients were discharged from the ward over 6 months using the new discharge form: 13 were discharged to a care home and 7 returned to their own home. The 13 patients’ discharged to care home were evaluated pre-discharge and post-discharge at 4 weeks by telephone to the care home. One patient died during this time.

Over the six months of the project 98% of professions engaged in the form’s completion. The 12 patients demonstrated an increase in their BMI, 42% improved or maintained their functional ability and 75% improved or maintained their quality of life. All care homes reported a benefit to the increased information to their care of the patient.

This impact of improved sharing of information from hospital to care home appeared to improve patients’ quality of life, function and BMI on their transfer to a care home setting.

 What were your conclusions?

The use of the new multi-disciplinary discharge form increased the level and consistency of information disseminated to a care home on discharge. The information aided care homes to shape their care for the patient.

There appears to be a positive impact of improving communication between the ward and care homes on patient outcomes as demonstrated through their BMI, Quality of Life and Functional Ability on discharge. However, this improvement was only measured over a short time frame with a limited number of patients, and without any control group.

What next for the project?

This project has shown that improved information sharing systems can increase the range of important clinical information that is shared and may benefit patient outcomes. I hope to continue to improve the discharge information sharing processes on the ward.

27 January 2017

Can good fat boost your fitness level? Angus Hunter in The Conversation


Dr Angus Hunter

Dr Mariasole Da Boit (University of Derby), Dr Angus Hunter (University of Stirling) and Dr Stuart Gray (University of Glasgow) have written in The Conversation:

“Fish oil supplements may seem like a relatively recent health fad but they have actually been produced in the UK on a large scale since 1935 by the company Seven Seas Ltd. Since then, the fish oil supplement market has continued to grow, with many beneficial effects claimed for health……….”

See the full article here.
24 January 2017

How bucket lists help the terminally ill – and those around them

edward-duncanDr Edward Duncan has written in The Conversation UK:

“Buckets lists – inventories of things to do before you die – are often developed by people who know they have little time left. It seems like a good idea. But are they really beneficial, or can they cause harm? And is it really useful to generate lists that may – either due to expense or illness – be perceived as unrealistic?”

Please click here for the full article.

15 December 2016

Why personal accounts of cancer treatment in Scotland matter

Why personal accounts of cancer treatment in Scotland matter: re-blogging a post for Macmillan Cancer Support Scotland by Prof Mary Wells.

Macmillan Cancer Support Scotland Blog

The publication of the personal patient accounts from the Scottish Cancer Patient Experience Survey provided instant publicity thanks to national media coverage but only reflected a fraction of what was in the report.

Compiled from an independent analysis of over 7,000 comments made by more than 2,500 people with cancer, these personalised responses are the stories of individuals whose experiences provide an insight into what matters most to people with cancer from diagnosis to end of treatment.

Whilst the results of the multiple-choice survey questions, published in June, provided an indication of the aspects of care which are experienced positively and those which leave room for improvement, they provide little detail of why or how individual patients experience those aspects of care.

The steering group for the first Scottish Cancer Patient Experience survey deliberately decided to include a greater number of these responses which had been used in the previous…

View original post 663 more words

Research with Impact: Investing in Tobacco, Alcohol and Substance Use Research

researchwithimpact_bannergreenThe University of Stirling Impact Research Studentships support outstanding novel research projects that can demonstrate a link to the Universities strategic priorities and be high impact. Researchers in Health Sciences were successful in gaining three of these awards in spring 2016.

Dr Crawford Moodie, Dr Niamh Fitzgerald and Dr Tessa Parkes appointed three excellent researchers to these studentships in summer 2016 and all three started their studies in October.   Our new colleagues will be contributing to the globally-recognised work of the Tobacco, Alcohol and Substance Use Research Group.


Andriana Manta

Andriana Manta will be working on a comparative analysis between Scotland and Greece. She aims to examine various genres of representations of the ‘drug problem’, how these representations are being reflected in the governance of the ‘drug problem’, as well as to explore possible associations with concerning changes in key indicators of public health among people who inject drugs for contributing to the wider community. The study will use a “what’s the problem represented to be” (WPR) approach to follow the construction of the drug problem, involving discourse analysis and visual analysis. The studentship is funded by the University of Stirling.

Andriana has a background in mental health research, having worked for the programme Anti-Stigma at the Athens University Mental Health Research Institute, where she was involved with both qualitative and quantitative methods of research on the stigma surrounding mental health conditions. Moreover, Andriana has an educational background in drugs and alcohol studies; she has also worked variously in the field of drugs and alcohol treatment, in Scotland and Greece, having gained a good grasp of the ‘drug problem’ realities faced by both countries.


Danielle Mitchell

Danielle Mitchell will be working in the Institute for Social Marketing on the use of innovative tobacco packaging to deter smoking. The study will use both qualitative and quantitative methods to explore beyond the recent implemented plain packaging in the UK, in order to discover innovative methods to further deter smoking both in terms of encouraging cessation and the onset of smoking in youth.

Danielle has a background in marketing with both a BA Honours Marketing degree and an MSc in International Fashion Marketing.  Having gained knowledge and experience from carrying out mixed methods research in both her undergraduate and masters dissertations, her interest for continuous research grew and the prospect of using marketing and research techniques to impact upon the behaviour of individuals in a positive manner whilst also contributing to valuable social research.


Clare Sharp

Clare Sharp will be working in the Institute for Social Marketing on a study which aims to understand how Nalmefene, a drug treatment for alcohol dependence, has been used in the UK, and the factors which have influenced prescribing for this drug. The study will used a mixed methods approach, involving quantitative analysis of prescribing data and qualitative methods to explore perceptions around the role of Nalmefene in treating alcohol dependence, key influences on prescribing behaviour and views about how the regulations and marketing of the drug have been handled.  The studentship is part-funded by Alcohol Research UK and the University of Stirling.

Clare has a background in social research, having worked in ScotCen Social Research for a number of years. Here, she gained considerable experience as a survey researcher, having been involved in the development, management and analysis of some of Scotland’s flagship surveys including Scottish Health Survey, Scottish Social Attitudes Survey, Growing Up in Scotland and the Scottish Crime Survey. Clare has also worked on mixed methods studies involving alcohol and tobacco, including the evaluation of the Alcohol Licensing Act and the DISPLAY project to evaluate the tobacco point of sale promotions ban.

Dr Tessa Parkes, Senior Lecturer, commented “We are delighted to welcome Danielle, Clare and Andriana to our Faculty and Research Group and wish them all well as they embark on their exciting projects.”

20 October 2016

Cancer and exercise do mix

“When you hear the word “cancer” probably the last thing that you think of is physical activity. In fact, most of us think of cancer as a death sentence. Treatments for cancer make many people feel lousy and the side effects of treatment include fatigue, anxiety, nausea, vomiting and pain. So it is hardly surprising that people who are diagnosed with cancer are not reaching for their running shoes or gym kit.”

Read Dr Gill Hubbard’s full article Cancer and exercise do mix in The Conversation.
19 October 2016

NHS Forth Valley Nurses Choir: proud to be nurses

20160702_145901bThe NHS Forth Valley Nurses Choir was born from an idea for Nurses Day which a couple of us put to our Director of Nursing, Professor Angela Wallace – she thought it was a great idea.

It didn’t happen immediately for various reasons including having someone to lead a Choir –  so as a challenge she made it one of my objectives!  It took ages to find someone to lead the Choir, however after some time and through a colleague (who is also a member of the choir), we found the lovely Phillip Todd.

He comes with a wealth of experience, as an actor, film editor, an award winning mod singer, and graduate of the Royal Conservatoire….. The Military Wives have Gareth Malone, but WE got the amazing Phil.

And so the Choir formed in September 2014.

By Christmas that year, we had sung for the Friends of the Hospital, the Health Board at the end of their meeting just before Christmas and the Patient Public Panel at their 10th Anniversary Celebration.

In addition we sang in the wards of one of our Community Hospitals.  What a lovely heart-warming experience that was!  In the dementia ward in particular, the patients sang along with the choir, every word they sang and their families were so delighted. We as nurses were all pretty emotional about that!

Funny story…..We had been asked to sing for the NHS Forth Valley Board Members at the end of their meeting, just before Christmas.  The hospital capacity had been challenging. I am usually in charge of the music.  I use my personal iPhone to play the music via blue tooth through speakers – so in general I stand at the front and at the end of the row.

As I am no technician I hold the iPod in my hand so I can start and stop the music etc.  At the end of the singing for the Board Members, a very senior Doctor came up to me and said well done Rita, How is capacity – what’s happening? as she looked to my phone in my hand?  I looked at her puzzled?  Then realised that she thought I had been texting back and fore – dishing out orders or something – as we were singing!!  I mean really??  I explained nicely that it was the music I was in charge of!  How I wish I was that smart!

We are very lucky to occasionally be able sing the Atrium of our lovely new hospital and as we do so we gather money for various charities, usually one which a choir member has nominated.

One year later in September 2015 we were nominated by members of the public for a Staff Award in the Volunteers category……. WE WON!  What a great achievement that has been for us [pictured].

Winner-Volunteer-Award-Nurses-ChoirThe Royal College of Nursing (RCN) asked us to entertain them at their Reps Conference in October 2015 in Edinburgh.  We were to sing 7 songs.  We were extremely nervous about that I guess, having a fear that it would not go down well.  Fear not!  Our singing went down a storm.  The audience (all nurses) know how to enjoy themselves.  You just have to picture a scene of a sea of people standing at the back their mobile phones in hand with the torch switched on and them swaying back a fore – it was so funny but gave the choir a good feeling.  They gave us a standing ovation!

Christmas time was very busy for us.  We were asked to be part of a Christmas concert for charity.  Some of our local doctors and nurses were heading out to Tanzania to man a ship called the Voyage of Hope and they needs funds – I guess that was our real first big audience.  It was a truly exhilarating experience for the Choir.  The feedback we got was tremendous and gave us a real boost in confidence.

The Nursing Standard got to hear about the Nurses Choir and came to meet with us and arranged a photographer to come along to take photos as we were singing in the Hospital Atrium one day.  They wrote “Forth Valley Nurses’ Choir is making a name for itself by singing at hospitals and charity events. Their audiences – including people with dementia – experience emotional release during the songs, while the nurses benefit from the camaraderie and wellbeing associated with singing in a choir”  We made the front cover of the Christmas Edition of the Nursing Standard.  Wow!

2016 has seen us grow and grow. While continuing to recruit more members we continued to sing different songs together.  The Choir is made up of many fields of nursing, all designations of nurses and in true nurse style have developed a fantastic team where everyone works together, something I personally, am proud of nurses for.  We wear uniform in public and we are proud to be nurses and represent nursing.

This year has seen us take parproud to be nurses and represent nursingt in the opening Ceremony of the Royal College of Nursing Congress – a HUGE event for nursing.  We are proud to have been asked.  During the ceremony our Nurse Director, Professor Angela Wallace, was given a tremendous award of a Fellowship of the Royal College of Nursing in recognition of her work for nursing.  Another proud moment for us, the Nurses Choir and for her to be honoured…… we were present woop wooping!  A great day for NHS Forth Valley Nurses.

We also were asked by the RCN to represent nursing as well as sing at the Scottish Government State Opening of Parliament celebrations.  Some of got to wear old-style uniforms dating back to the early 20th century.  It was a thrilling day being part of the procession down the Royal Mile as well as getting to do what we love…. SINGING.


NHS Forth Valley Nurses Choir pictured at the Opening of the Scottish Parliament

We are having our summer break right now but are due to start back in early September with already a charity concert booked at the end of September….. I wonder what the rest of 2016/2017 will bring for us?

© Rita Ciccu-Moore and Lynne Paterson, NHS Forth Valley
2 September 2016

You can view the Choir singing here: